Janet Street-Porter: What's wrong with the idea of family GPs?

Wednesday 28 January 2009 00:00 BST

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It's right that the NHS should look at ways of improving its impact on the environment. It's responsible for a quarter of all carbon emissions in the public sector. Yesterday, it published new guidelines, in a document entitled "Saving Carbon, Improving Health". Reading it, you can't help but notice how our relationship with doctors and the medical profession has changed radically over the last decade.

In many ways, the NHS would function just brilliantly if it didn't have to contend with that troublesome person known as a patient. The jargon employed by the NHS sustainable development unit to describe its proposed energy-saving strategy resembles nothing more than Birtspeak, that degradation of the English language perfected by John Birt as director general of the BBC.

Birt invented something called "producer choice" in which everything had to be costed and recharged back into the accounting system. It drove rational people nuts, demoralised the staff and cost a fortune, involving endless consultants who had to explain the brave new Birt world to me and other underlings. Even today, the BBC still speaks an internal language as indecipherable to outsiders as Esperanto.

We all want to do our bit for the environment, but the NHS seems to have forgotten, in the midst of setting all these targets and objectives, that its core business is to care for people, to make the sick feel better and to improve our health, not to cause us unnecessary stress and inconvenience. To most of us, a trip to the doctor is still regarded as essential if you feel really under the weather. But hang on! In the new NHS, did you realise that this is increasing its carbon emissions in an unacceptable way?

By 2007, around half of the NHS trusts had drawn up a Sustainable Travel Plan for their staff. These included plans to loan tax-free bicycles, and invest in buses to ferry staff from one site to another. Now, the NHS bosses want to monitor the travel "consequences" (the means of travel and distance) of all staff and patients, and want trusts to review the need for people to see doctors face to face. It's proposed that video-conferencing and telephone calls are a viable alternative.

All NHS organisations will have to report on visitor transport mileage and patient transport mileage. You know where this is going to lead us, don't you? All car parks around hospitals will be dug up before you know it. Even though many trusts inflict exorbitant parking charges on people visiting their sick relatives, they will be forced by the Government to give up this lucrative source of income in favour of saving the planet. Visitors will have to travel to hospitals and the local health centre by public transport, cycle or walk.

The notion that immigrants for whom English may be difficult, the elderly, and harassed young mums with a sick baby will be happy with talking to a doctor over the telephone is chilling, and once again demonstrates that the bean-counters at the NHS put patient satisfaction very far down their list of priorities.

NHS Direct already offers a 24-hour advice service over the telephone and it is swamped at weekends. There also are plenty of examples of misdiagnosis over the telephone. As it is, a visit to the doctor has to be booked well in advance, and the time allocated often seems too short anyway.

For a population that has an increasing number of single and older people, who may feel isolated, the doctor plays a key role in identifying other problems, and is often the only person these patients may actually talk to.

The government has said that it wants to dispense with the old notion of the family doctor and instead create super-surgeries where staff work in a pool. Now they are planning to go one stage further and make it even harder for people to see a doctor at all.

Why are they determined to eradicate traditional GPs and replace them with pharmacists and disembodied voices on a phone line? GPs are a valuable resource and a key part of the local community. Shame that the NHS doesn't agree.

Names reveal nothing about how someone might behave

Alistair McClean thought he'd come up with a novel way to flog his up-market holidays: emailing 24,000 potential customers to boast that they were unlikely to meet common people with names like Britney, Chardonnay, Chantelle and Shannon on an Activities Abroad break.

He proudly listed the posh names his well-heeled clients were likely to encounter – John, Sarah, Alice and Charlotte, implying that chavs wouldn't feel at home. When the complaints poured in, he ranted on the internet: "I make no apology for proclaiming myself to be middle class."

Names are no guarantee of breeding and class these days – Chelsy Davy not only has a chav name, she dresses like one too. And Prince Andrew's poshly-named daughter Eugenie certainly behaves like the lower orders, arriving at a pole-dancing club at 4am the other morning, accompanied by the police protection officer which the public has to pay for. She seems to spend more than a few nights drinking, so let's not attack chavs.

These stickers are a bit ripe

Supermarkets plan to put colour-coded stickers on fruit to tell us if it's ripe or not. They claim that the scheme will help reduce waste because we can choose fruit that's juicy.

It's also a way to charge more for stuff that's actually edible rather than something that tastes like a piece of cardboard? Ripe avocados already cost more in some stores.